摘要目的:观察玻璃体腔注射康柏西普（IVC）联合阈值下微脉冲激光（SMLP）治疗糖尿病黄斑水肿（DME）的疗效。方法:随机对照试验。2020年12月至2022年1月于山西爱尔眼科医院检查确诊的DME患者100例100只眼纳入研究。采用简单随机化法将患者分为单纯IVC组、IVC+SMLP组，各50例50只眼。患眼均行IVC治疗，每一个月1次，连续3次；IVC+SMLP组患眼IVC后2周内行SMLP治疗。所有患眼采用对数视力表行最佳矫正视力（BCVA）检查，统计时转换为最小分辨角对数（logMAR）视力；采用光相干断层扫描检查测量患眼黄斑中心凹厚度（CMT）。治疗前，单纯IVC组、IVC+SMLP组患眼logMAR BCVA分别为0.56±0.04、0.55±0.03；CMT分别为（437.36±11.35）、（434.58±10.88）μm。两组患眼logMAR BCVA、CMT比较，差异均无统计学意义（ t=0.476、1.027， P>0.05 ）。治疗后随访12个月，对比观察两组患眼IVC次数以及BCVA、CMT的变化情况。组间logMAR BCVA、CMT、IVC次数比较采用独立样本 t检验。 结果:治疗后12个月，单纯IVC组、IVC+SMLP组患眼logMAR BCVA分别为0.29±0.11、0.28±0.13；CMT分别为（241.63±29.79）、（240.47±30.46）μm。与治疗前相比，治疗后12个月，两组患眼BCVA显著提高，差异均有统计学意义（ t=7.014、5.608， P<0.001）；CMT显著降低，差异均有统计学意义（ t=8.126、6.013， P<0.001 ）。两组患眼间BCVA、CMT比较，差异均无统计学意义（ t=0.835、0.764， P>0.05 ）。单纯IVC组、IVC+SMLP组患眼IVC次数分别为（8.15±2.04）、（5.91±1.80）次，差异有统计学意义（ t=5.210， P<0.001 ）。 结论:IVC+SMLP与单纯IVC均可有效降低DME患眼CMT，提高BCVA；联合治疗可以减少IVC次数。

abstractsObjective:To observe the efficacy of intravitreal injection of conbercept (IVC) combined with subthreshold micropulse laser photocoagulation (SMLP) in the treatment of diabetic macular edema (DME).Methods:A randomized controlled trial. From December 2020 to January 2022, 100 patients (100 eyes) with DME diagnosed by examination in Shanxi Aier Eye Hospital were included in the study. The patients were randomly divided into IVC group (50 eyes) and IVC+SMLP group (50 eyes). All the eyes were treated with IVC once a month for 3 times, and the eyes in IVC+SMLP group were treated with SMLP within 2 weeks after IVC. All affected eyes were examined by best corrected visual acuity (BCVA), which was statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. The central macular thickness (CMT) was measured by optical coherence tomography. Before the treatment, the logMAR BCVA of patients in IVC group and IVC+SMLP group were 0.56±0.04 and 0.55±0.03, respectively. The CMT were (437.36±11.35) μm and (434.58±10.88) μm, respectively. There was no significant difference in logMAR BCVA and CMT between the two groups ( t= 0.476, 1.027; P>0.05). The patients were followed up for 12 months after treatment. The times of IVC and the changes of BCVA and CMT were compared between the two groups. Independent sample t-test was used to compare the logMAR BCVA, CMT and times of IVC between groups. Results:After 12 months treatment, the logMAR BCVA of IVC group and IVC+SMLP group were (241.63±29.79) μm and (240.47±30.46) μm, respectively. Compared with those before treatment, 12 months after treatment, the BCVA of the two groups increased significantly ( t=7.014, 5.608; P<0.001), while CMT decreased significantly ( t=8.126, 6.013; P<0.001). There was no significant difference in BCVA and CMT between the two groups ( t=0.835, 0.764; P>0.05). The number of IVC in IVC group and IVC+SMLP group were (8.15±2.04) times and (5.91±1.80) times, respectively, and the difference was statistically significant ( t=5.210, P<0.001). Conclusions:Both IVC+SMLP and IVC alone can effectively reduce CMT and increase BCVA in patients with DME. Combination therapy can reduce the number of IVC.